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29 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Mgmt strategies differ for dysphagia patients with __ as opposed to ___ disorders
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degenerative, sudden-onset
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p. 303
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What is usually significantly reduced in all neurologically impaired dysphagia patients?
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Sensitivity to aspiration
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p. 304
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Dysphagic patients w/ stroke may exhibit reduced pharyngeal and supraglottic sensation -- T or F?
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T
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p. 304
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In patients who fatigue easily, __may not be appropriate
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Swallow maneuvers
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p. 305
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Why?
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B/c they increase fatigue
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p. 305
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WHat things may be appropriate instead, w/ patients who fatigue easily (4 things)?
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smaller meals, sensory stimulation, diet changes, posture changes
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p. 306
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In the intensive care unit, swallowing eval. should wait until __
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patient is extubated
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p. 306
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How long may it take for pharyngeal swallow to re-start after extubation?
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1 week
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p. 305
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WHat can be done to assess patients who are comatose?
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1)Put hand on the neck and submandibular area (as described in chapter 5), hold it for 5-10 minutes to assess frequency and strength of swallow
2) use surface electromyography to do same |
p. 305
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What else can be done besides palpation and electromyography?
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See how patient handles secretions
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p. 305
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If a stroke is limited to the posterior cortex (no motor function involved) will not usually develop dysphagia -- T or F?
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T
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p. 307
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Patients w/ unilateral medullary (lower brainstem) lesions typically exhibit__
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near-normal oral control, impaired trigger of pharyngeal swallow. Also, absence of pharyngeal swallow 1 week post-stroke.
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p. 308
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When swallow triggers, patients may exhibit __, __, and possibly __
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reduced laryngeal elevation and UES opening, unilateral pharyngeal weakness, unilateral adductor paresis
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p. 309
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About when does swallow recover for stroke patients such that they can restart oral intake?
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3 weeks post-stroke
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p. 309
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Patients w/ pontine (higher brainstem) stroke often experience__
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hypertonicity
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p. 309
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Hypertonicity in these patients manifests itself as __, __, and __
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delayed trigger of PS, reduced laryngeal elevation, unilateral spastic paralysis of the pharyngeal wall
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p. 310
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Patients w/ hypertonicity may not respond normally to head rotation -- T or F?
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T
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p. 310
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Patients w/ hypertonicity may benefit from __
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Massage to release excess muscle tone prior to swallow therapy session
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p. 310
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Patients w/ subcortical stroke may experience___, __, and __
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delayed oral transit, delayed trigger of the PS, and neuromuscular timing impairments of pharyngeal swallow
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p. 310
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As a result of these impairments, these patients may exhibit __
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aspiration before or after the swallow
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p. 310
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REcovery may take __ for these patients if there are no further complications
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3-6 weeks post-stroke
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p. 310
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For these patients, therapy may include __ and __
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improve triggering of PS, ROM motion for larynx and tongue base
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p. 310
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Stroke in the anterior left cortext may lead to __
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apraxia of swallow
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p. 310
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left cortical stroke patients may also experience __, __ and __
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delays in oral and pharyngeal transit, delay in PS trigger
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p. 310
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Patients w/ right hemisphere stroke exhibit longer __ than __
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pharyngeal, oral transit delays
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p. 311
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Patients w/ right hemisphere stroke may benefit from __ and __
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chin-down posture, thermal-tactile stim.
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p. 311
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They may also benefit from
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airway protection thru supraglottic, super-supraglottic maneuvers; ROM exercises for laryngeal elevation
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p. 311
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Patients w/ right hemisphere stroke may take longer to return to oral feeding b/c __
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they have cognitive disorders, inattention
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p. 311
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To date, no age effects have been ID'd on post-stroke recovery of swallow function -- T or F?
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T
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p. 313
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